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General NPI Number Information
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NPI Number | 1972648145
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Entity Type | Individual
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Provider Name | KATHRYN JOAN ROSS RN, FNP
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Gender | Female
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 11920 WILSON PARKE AVE
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City | AUSTIN
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State | TX
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Zip | 78726-4052
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Country | US
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Telephone | 512-258-5171
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Fax | 512-258-7762
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Provider Business Mailing Address
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Address Line | 2513 EASTSIDE DR
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City | AUSTIN
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State | TX
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Zip | 78704-5605
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Country | US
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Telephone | 512-442-9567
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Fax | 512-442-3854
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 421403
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License Number State | TX
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